The mother of Psychiatric Nursing 2o

The mother of Psychiatric Nursing “Hildegard PEPLAU’’ (1909 -1999) : 

The mother of Psychiatric Nursing “Hildegard PEPLAU’’ (1909 -1999)

“Hildegard Peplau” Psychodynamic Nursing : 

“Hildegard Peplau” Psychodynamic Nursing Background Hilda Peplau was born September 1, 1909, in Reading Pennsylvania. As a child, she witnessed the devastating flu epidemic of 1918. This personal experience greatly influenced her understanding of the impact of illness and death on families.

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From 1943-1945 Peplau served in the Army Nurse Corps and was assigned to the 312th Field Station Hospital in England where the American School of Military Psychiatry was located. Peplau held master's and doctoral degrees from Teachers College, Columbia University. She was also certified in psychoanalysis by the William Alanson White Institute of New York City. In the early 1950s, Peplau developed and taught the first classes for graduate psychiatric nursing students at Teachers College.

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Dr. Peplau was a member of the faculty of the College of Nursing at Rutgers University from 1954-1974. At Rutgers, Peplau created the first graduate level program for the preparation of clinical specialists in psychiatric nursing. Peplau vigorously advocated that nurses should become further educated so they could provide truly therapeutic care to patients rather than the custodial care that was prevalent in the mental hospital of that era. During the 1950's and 1960's, she conducted Summer workshop for nurses throughout the United States, mostly in state psychiatric hospitals. In these seminars, she taught interpersonal concepts and interviewing techniques, as well as individual, family and group therapy.

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Peplau was an advisor to the World Health Organization and a visiting professor at universities in Africa, Latin America, Europe and throughout the United States. After her retirement from Rutgers, she served a visiting professor at the University of Leuven in Belgian in 1975 and 1976. There she helped establish the first graduate nursing program in Europe. On March 7,1999,Hildegard died peacefully at her home in Sherman Oaks, California after a brief illness at the age of 89.Hildegard Peplau’s 50-years career in nursing left a remarkable stamp on the profession, and on the lives of the mentally ill around the world.

MAJOR CONCEPTS AND DEFINITIONS : 

MAJOR CONCEPTS AND DEFINITIONS PSYCHODYNAMIC NURSING Peplau defines psychodynamic nursing because her model evolves through this type of nursing. Psychodynamic nursing is being able to understand one’s own behavior to help others identify felt difficulties, and to apply principles of human relations to the problems that arise at all levels of experience.

Metaparadigm in Nursing : 

Metaparadigm in Nursing NursingNursing described as a significant, therapeutic, interpersonal process.PersonPeplau defines person in terms of man. Man is an organism that lives in an unstable equilibrium.HealthPeplau defines health as a word symbol that implies forward movement of personality and other ongoing human processes in the direction of creative, constructive, productive, personal, and community living.

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EnvironmentPeplau implicitly defines the environment in terms of existing forces outside the organism and in the context of culture, from which mores, customs, and beliefs are acquired.

Factors Influencing Orientation Phase : 

Factors Influencing Orientation Phase

The four phases of nurse-patient relationships are: : 

The four phases of nurse-patient relationships are: 1. Orientation: During this phase, the individual has a felt need and seeks professional assistance. The nurse helps the individual to recognize and understand his/ her problem and determine the need for help. 2. Identification The patient identifies with those who can help him/ her. The nurse permits exploration of feelings to aid the patient in undergoing illness as an experience that reorients feelings and strengthens positive forces in the personality and provides needed satisfaction.

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. Exploitation During this phase, the patient attempts to derive full value from what he/ she are offered through the relationship. The nurse can project new goals to be achieved through personal effort and power shifts from the nurse to the patient as the patient delays gratification to achieve the newly formed goals. 4. Resolution The patient gradually puts aside old goals and adopts new goals. This is a process in which the patient frees himself from identification with the nurse.

APPLICATION OF INTERPERSONAL THEORY IN NURSING PRACTICE : 

APPLICATION OF INTERPERSONAL THEORY IN NURSING PRACTICE Peplau’s theory focuses on the interpersonal processes and therapeutic relationship that develops between the nurse and client. The interpersonal focus of Peplau’s theory requires that the nurse attend to the interpersonal processes that occur between the nurse and client. Interpersonal process is maturing force for personality. Interpersonal processes include the nurse- client relationship, communication, pattern integration and the roles of the nurse. Psychodynamic nursing is being able to understand one’s own behavior to help others identify felt difficulties and to apply principles of human relations to the problems that arise at all levels of experience. This theory stressed the importance of nurses’ ability to understand own behavior to help others identify perceived difficulties.

Overlapping phases in nurse- patient relationship : 

Overlapping phases in nurse- patient relationship

Peplau’s theory and nursing process: : 

Orientation: Nurse and patient come together as strangers; meeting initiated by patient who expresses a “felt need”; work together to recognize, clarify and define facts related to need. Identification: Patient participates in goal setting; has feeling of belonging and selectively responds to those who can meet his or her needs. Exploitation: Patient actively seeks and draws knowledge and expertise of those who can help. Resolution: Occurs after other phases are completed successfully. This leads to termination of the relationship. Peplau’s theory and nursing process:

NURSING ROLES : 

NURSING ROLES 1. Stranger Role: Receives the client the same way one meets a stranger in other life situations; provides an accepting climate that builds trust. Accepting the patient objectively. 2. Resource Person Role: Answers questions, interprets clinical treatment data, gives information. Interpreting the medical plan to the patient. 3. Teaching Role: Gives instructions and provides training; involves analysis and synthesis of the learner's experience. Offering information and helping the patient to learn.

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Peplau separates teaching into two categories : Instructional—which consists largely of giving information and is the form explained in educational literature. Experiential— which is using the experience of the learner as a basis from which learning products are developed. 4. Counseling Role: Helps client understand and integrate the meaning of current life circumstances; provides guidance and encouragement to make changes. Working with the patient on current problems.

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5. Surrogate Role: Helps client clarify domains of dependence, interdependence, and independence and acts on client’s behalf as advocate. Figuratively standing in for a person in the patient's life. 6. Active Leadership Role: Helps client assume maximum responsibility for meeting treatment goals in a mutually satisfying way. Working with the patient democratically.

Example of a clinical Practice : 

Example of a clinical Practice . Orientation phase Client is initially reluctant to talk due to pain. Client is expressing that while standing she is having much pain. Client expressed without movement and supine position gave her relief from pain.  2. Identification The client participates and interdependent with the nurse Expresses the need for measure to get relief from pain Expresses need for improving the mobility Expresses need to know more about prognosis, discharge and home care and follow up.

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. Exploitation Client explains that she gets relief of pain when lying down supine. Cooperates and participates actively in performing exercises. Client mobilizes changes position and cooperates during position changes. 4. Resolution Client expressed that pain has reduced a lot and she is able to tolerate it now She has agreed upon to continue the exercises at home She also expressed that she would come for regular follow up after discharge.

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Peplau (1987) viewed psychiatric nursing as a viable, complimentary and necessary alternative to psychiatric-medical treatments. She encouraged nurses to be proud of the development of nursing and challenged us to remember that… Somewhere, somehow, at some time in the past, courageous nurses determined these skills, learned them, fought for the right to use them, refined them, and taught them to other nurses. All nurses have an obligation to remember that part of nursing’s past, and to keep their own skills in pace with new opportunities for nursing into the next century. (Peplau, 1989, p.32) Peplau was one such courageous woman who has left us a legacy of practical knowledge to enable the survival and continued development of nursing. We are forever in her debt.

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Evaluation of the theory of interpersonal relations by Peplau :With the help of the theory of interpersonal relations, the client's needs could be assessed. It helped her to achieve them within her limits. This theory application helped in providing comprehensive care to the client.

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The essence of Peplau's theories is the creation of a shared experience. Nurses, she thought, could facilitate this through observation, description, formulation, interpretation, validation, and intervention.For example, as the nurse listens to her client she develops a general impression of the client's situation. The nurse then validates her inferences by checking with the client for accuracy. The result may be experiential learning, improved coping strategies, and personal growth for both parties.Peplau's theory improves the relationship between the nurse and the patient which is a great factor for the development of our nursing practice...

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Presented to: Mrs. Jenalyn San Luis Presented by: The Peplau Group.. Kristine tiara Peña , Jelli Tuazon , Mary Flor Paongan